What to do if the road gets bad

Passengers of train No. 209, following the route Labytnangi - Moscow, worried for five hours about a 60-year-old man who had a heart attack. The incident took place on June 21 this year. A man who had previously suffered a stroke was traveling with his family to reserved seat car when he got sick. The attack began in the morning at about 10 o'clock, after which the conductors began to look for doctors among the passengers in neighboring cars. We managed to find two doctors, they were next to the patient for several hours. At the same time, the train crew did not have any medicines.

The man's condition worsened, his breathing stopped, but this section of the track does not pass between major stations, and the first ambulance brigade waited for the train only at the Kostylevo station at 13.30.

Kostylev's doctors examined the man in the carriage, gave an injection, delaying the train for 15 minutes, and said that they could not help him: “He is in a serious condition, he needs to be hospitalized, but we have nowhere, we have to take him to Velsk.”

As a result, the patient was taken more than an hour to Velsk, where the second ambulance team hospitalized the victim. As a result, at least five hours passed from the moment of the attack to hospitalization. Eyewitnesses were indignant not only about the delay in the provision of medical care, but also about the strong closeness in the car - the patient only got worse because of this. To alleviate the condition of the man, I had to keep open doors in the vestibule

“We have either ventilation in our cars, or boiling water in titanium. The police travel on the train, but there are never any doctors,” one of the conductors explained the stuffiness on the train, in which more than five hundred people were traveling.

Passengers are cold and poisoned

Complaints about inadequate temperature regime in carriages - one of the most common among passengers. “Last year, on May 4, we returned from Kazan, there was some additional train, because they ran out of scheduled tickets, ”Margarita Verkhovskaya, a resident of Moscow, told Gazeta.Ru. - Frosts began, and the train had a broken heating system.

It was terribly cold, five degrees, no more. There were no extra blankets, nothing to keep warm.

The head of the train refused to do anything about it. I arrived in Moscow and immediately fell ill with a temperature, I had to take sick leave. I wrote a complaint to the RZD website. A few months later the answer came: they say, everyone was punished. But the names of the conductor and the head of the train did not match, so it seems to me that it is unlikely that an investigation into this matter was carried out.

When asked about what the company is doing in connection with passenger complaints about stuffiness in trains or too much air conditioning, the FPC replied that “the conductor passenger car must promptly respond to the requests of passengers, to the extent possible, fulfill the wishes of passengers. Special attention at the same time, it is given to passengers with limited mobility, the elderly, passengers with children. For understanding: in cars with forced ventilation and air conditioning installation, ventilation must operate continuously in automatic mode, depending on the air temperature in the car.”

However, health problems may arise in passengers not only because of stuffiness or frost in the cars. President of the League of Patient Defenders Alexander Saversky told Gazeta.Ru that two years ago, when he was traveling with his family by train to Kislovodsk, he and eight other people in the car got severe food poisoning after trying "on-board meals" that can be ordered at train.

“My wife and child and I were almost taken off the train and deprived of rest in the sanatorium where we were going, they thought that we had some kind of infection. At the same time, we did not receive any medical assistance for 12 hours, there was no doctor on the train and he was not called to the station, ”Saversky explained.

What help to expect from Russian Railways

Such cases are not isolated - every year in Russian trains, at stations, platforms and other facilities railway transport health care Approximately 1 million people. And 70,000 sick passengers seek help at medical stations at stations located along the route of the train, according to statistics from the Federal passenger company(FPK).

If the passenger becomes ill, then the first thing to do is to call the head of the train, the rules say.

It is he who must contact the medical workers who will be waiting for the train at the nearest station, and also find out by “loudspeaker” or through the conductors whether there are doctors among the other passengers. At the same time, the conductors themselves can only provide the passenger with first aid, because they are not medical workers.

For first aid, special medical packages (first aid kits) are stored on the train. There, in particular, there are means to temporarily stop bleeding, products for pulmonary resuscitation - for newborns and adults - a hypothermic package, an isothermal rescue blanket, splints in case of fractures, frameless stretchers, etc.

Saversky and eight passengers who were poisoned were to be treated right on the spot.

Train staff regularly undergo training, where they are explained how to help a person with “injuries, various poisonings, foreign bodies, wounds, squeezing of limbs, bleeding, fractures, bruises, sprains, dislocations, burns and frostbite.” The press service of the FPK Gazeta.Ru explained that the training program also includes first aid for people affected by the action of electric current, methods of performing artificial respiration and external heart massage, first aid for heat and sunstroke, as well as for epileptic fit.

If there is no threat to life, then the called doctors organize a relay medical escort to the destination or send the passenger to the nearest hospital where they can help him. If the life or health of a passenger was harmed while being transported by train, then the case is recognized as insured - the FPC has a contract of compulsory insurance of the carrier's civil liability. In addition, passengers can additionally take out voluntary accident insurance policies when they buy tickets at FPC ticket offices or on the Russian Railways website.

True, it is not easy for passengers to get money for “automatic” insurance, lawyers admit. It is quite difficult to prove that the harm to health was caused precisely during transportation, unless some kind of accident occurred. And in cases of poisoning or a cold, it is recommended to send a complaint to Russian Railways and collect testimony from witnesses. And even if all the documents are in hand, “litigating such cases means wasting a couple of years of your life without a guaranteed result,” sums up the president of the League of Patient Defenders.

Have you ever been on a train with medical compartments, with a laboratory and a receptionist in the car? I have not been and, anticipating a visit to the clinic on wheels, hurried along the platform railway station Minino. The Mobile Consultative and Diagnostic Center "Doctor Voyno-Yasenetsky - St. Luke" settled here for two days. The Health Train, as it is more often called, will celebrate its 10th anniversary this year.

From the outside, the Health Train looks like a regular train. Only the last one with the image of the Holy Princess Olga stands out from the snake of carriages. This is a temple car. On the threshold of the fourth car - the conference room - I meet the eyes of Professor Voyno-Yasenetsky. The patron of the train looks thoughtfully from a wall portrait. “Hello, come in!”, Yekaterina Samsonyuk invites from behind a long table. She has been running the Health Train for two years. “Our train is a joint project of the Russian railways”and the Government of the Krasnoyarsk Territory,” recalls Ekaterina Georgievna. - We provide residents of remote areas with free quality medical care. We cruise on Krasnoyarsk Territory, Khakassia, we capture part of the Kemerovo and Irkutsk regions.

The health train arrives at each station once a year. When the mobile polyclinic was just starting to work, doctors were receiving at 55 stations. Today there are 75 of them. For 10 years, the Health Train had 552 stops and 94 business trips. 147,257 people were examined in the medical center on wheels. Behind the dry figures are the saved lives of people who were diagnosed with serious illnesses on the train. “Last year, a patient with a dissecting aortic aneurysm was rescued. They suspected that he had a dangerous pathology and sent him to be examined in a regional hospital. There, the man was immediately operated on, - Ekaterina Samsonyuk gives an example. “We also detect a lot of oncology, heart disease (including in children), peptic ulcer, tuberculosis.”

For accurate diagnosis, the Health Train has the most modern equipment. Let's go watch it. Ekaterina Georgievna confidently leads me between the cars and tells me on the go: “More than 70 people work on the train: 17 doctors, 20 paramedics, security guards, cooks, conductors. The conductors clean the cars three times a day, the guards keep order, help elderly patients get into the car. Behind technical side- uninterrupted supply of water, fuel, electricity and much more - the head of the train Svetlana Anatolyevna Vagner answers.

We enter the check-in car. The reception desk is also the reception desk on the train: a counter with windows, stacks of medical cards on the shelves. There are no usual queues. “The main flow of patients comes in the morning. Today there were more than 100 people, ”explains the registrar Daria to the noise of a freight train rushing past the window. And we move on. We pass the offices of the therapist and the pediatrician - they are not up to me now, they are busy with patients. “We have two therapists,” says the leader of the Health Train. - Patients can visit a general practitioner first or go straight to a specialist without a referral. It's comfortable". During the day, visitors to the mobile clinic manage to get around all the necessary doctors. ENT, gynecologist, urologist, dentist, endocrinologist, neurologist, ophthalmologist, surgeon...

In the office of the surgeon Yevgeny Potapov is still free. Congratulations from colleagues flaunt on the walls of the compartment.

- Is it your birthday today?

Yes. Colleagues made a surprise, - the doctor says embarrassed. - There were also balloons, I gave them to little patients.

- Congratulations! What do patients usually come to you for?

With everything (smiles). With pains in the joints, abdomen, back, chest, arms and legs. I examine a person and, depending on the indications, refer them to blood and urine tests, endoscopic diagnostics, ultrasound, X-rays. All this is done in our train. If a person comes with ready-made test results, I can immediately prescribe treatment. But I don’t perform surgical manipulations - there are no conditions here. If the patient is "emergency", I call an ambulance to be taken to the nearest hospital. Such cases are not uncommon. In January, a 15-year-old boy came to me with ulcer bleeding. And the day before yesterday there was a 6-year-old girl with acute complicated appendicitis. Both were hospitalized (there was a knock on the door). Come in, come in.

Ekaterina Georgievna is waiting outside the door. We're going to the lab. “At the end of 2015, the equipment was updated here,” my companion says at the door of the spacious laboratory. Laboratory assistant Galina Laletina joins the conversation. “This device (she points to a white cabinet with a screen) determines the level of glucose in the blood. We also conduct detailed and biochemical blood tests, a general urine test. All studies take 1 hour and 20 minutes. At this time, the patient bypasses the necessary doctors, and when he is released, the results of the tests are already with the therapist. Some tests (gynecological smears, biopsy) take longer to prepare. Their results are sent to the district hospitals where the patient is attached. And the doctors of the Health Train interact with each other through the information system. All protocols in in electronic format, - explains Ekaterina Samsonyuk. “Thanks to this, the doctor, without leaving the office, can see the records of colleagues.”

A nurse peeks out from the optometrist's office:

Come check your eyesight!

- And I'm without a card, I'm a journalist.

Well then... Okay, come on while there are no patients.

The verdict of the ophthalmologist Oleg Fedchenko: - 1.0. “Pick up your glasses boldly,” he admonishes at parting. And again the door to the next car. It's time for an X-ray. “That's so giant!”, - I think, looking at the huge white apparatus. “This is our new digital x-ray machine. With it, you can take any pictures, not just fluorography, - explains Ekaterina Georgievna. - The device weighs more than a ton. To install it and prevent overweight in one direction, the engineers changed the design of the car, mounted special fasteners. Specialists check the serviceability of the equipment at the beginning of each business trip.”

Next to the X-ray machine is his "brother" - a digital mammograph. All equipment of the Health Train cannot be counted: endoscopes, ultrasound machines, electrocardiograph, equipment for functional diagnostics... There are all resources for telemedicine consultations with colleagues from regional and federal clinics. “Now we hold such consultations less often: there are fewer complex neglected cases. There were plenty of them when the train was just starting to work. And no wonder: in some villages there is not even a feldsher-midwife station. People have nowhere to turn for medical help,” says Kateryna Samsonyuk.

The realities of the Siberian hinterland stunned foreign journalists who visited the Health Train in the winter. “In January correspondents from Germany traveled with us. There was a business trip to the north, to Lesosibirsk. There were frosts at 45 degrees, - says my interlocutor. - The Germans were surprised how we endure such a cold (laughs). They were amazed that people even in a 40-degree cold go to the Health Train. Indeed, in Germany there are no problems with the availability of medicine and there are no such large territories like we have in the region.

In the cold, in the heat, on holidays and weekends, the train of health rushes to where the help of doctors is needed. Some villages do not telephone communication and no communication other than the railroad. “Sometimes local doctors twice my age come and ask: “What to do in such and such a situation? There is not always a connection to consult with colleagues, but the decision must be made now,” says the head of the Health Train. I know I know. Not without reason, in 2015, the staff of the mobile medical center became the laureate of the Sibmedportal "Vocation - Doctor" award in the nomination "For work in extreme conditions". By the way, about the conditions.

- Ekaterina Georgievna, how is the life of doctors on the Health Train arranged? How long are business trips?

We have a shift schedule: we work for 15 days and rest for the same amount. During a business trip, my colleagues and I are always together, like on a submarine (smiles). Medics and other employees of the train live in compartments in twos. In the "non-medical" cars there are showers and a dining room.

- From 8 a.m. to 6 p.m., doctors of the Health Train are receiving patients. And in free time what you are doing?

Reading, walking, playing sports. We have our own volleyball team on the train. In some areas we arrange friendly matches with local athletes. In Kansk and Lesosibirsk we go to the pool.

- In general, do not sit on the train for days. And all the same. Half a month on wheels… Not everyone can work like that.

Yes, but we have a permanent team. Some have been working since the very first trips of the Health Train. I first worked as a urologist. I quickly got used to traveling work. It's already a way of life. Before you have time to unpack your bags after a business trip, you are going to hit the road again (laughs).

It's time for Ekaterina Georgievna to go to her office - business. Am I still wandering around on the train next time I stop by here? There are queues in some carriages. Grandmothers perched on folding seats, children look at something through the train window. The younger girl hugged her mother. She reassures: "Don't be afraid, the doctor will just look." There are several people outside the therapist's office. They ask each other in a narrow corridor: “Have you already passed everyone?” “This is my first time on the Health Train. I visited a surgeon, a gynecologist, a urologist, an ENT doctor, an ophthalmologist. The doctors here are great. Attentive, friendly, - patient Tatyana shares her impressions. - We do not live in the outback, from Minino less than 30 km to Krasnoyarsk, but getting to the doctor is a problem. I have to go through Krasnoyarsk to the Emelyanovskaya district hospital. It is difficult to get to the surgeon there, and there is no laura at all. Fortunately, the health train is coming. Our community needs him." And many, many others too.

"Anastasia," Tatyana called as I made my way to the exit. - Please write in the article that we, the patients, congratulate the Health Train on its 10th anniversary. We wish the doctors health, patience and that they always work so well!”.

Anastasia Lemenkova

No one is immune from a sudden deterioration in well-being. It can be banal poisoning, and pressure surges, and exacerbation of chronic diseases. What should you do if you or a fellow traveler feels unwell?

First of all, you need to assess the condition. As a rule, many people carry with them a “camping” first aid kit with tested drugs that may be needed on the road. You may be able to get by with a "home stock". Remember that guides do not have medicines in first-aid kits - this is prohibited by order of the Ministry of Health and Social Development. The train first-aid kit contains bandages, cotton wool, a dressing kit, tourniquets - the absolute minimum. Now pharmacy stacks are also equipped with hypothermic bags, an isothermal rescue blanket, splints in case of fractures, and frameless stretchers.

If something more serious happened - for example, heart problems, a fracture or a sharp exacerbation of chronic diseases, then you can only rely on the endurance of your own body and a little - on Lucky case. The guides are medically trained, but few of them have encountered situations where you need to give a heart massage or stop heavy bleeding. Actually, conductors are forbidden to perform such actions - they are not medical workers and have the right to provide only first aid. IN extreme situations the conductor, using the announcement on the speakerphone, is looking for a doctor among the passengers. This is the very happy case that can save someone's life.

The head of the train, through the driver, calls a team of doctors to the nearest station. From there, the victim will be taken to the nearest hospital.

Moscow - St. Petersburg is the most popular railway line in Russia. Every year, 8.5 million passengers travel between the two capitals. Evgeniy Trofimchuk, director of recreation at the OneTwoTrip online travel service, decided to find out everything about the trains running along the route, and for two weeks he rode non-stop from Moscow to St. Petersburg and back ..

First aid kit will not be provided

Trains have special medical packs (first aid kits), but you will not find pills in them. The fact is that, according to the rules, conductors do not have the right to give passengers pills or medicines, since they do not have a medical education. Nevertheless, guides still undergo the minimum required training: everyone can provide first aid, stop bleeding, make bandages and even take birth.

If someone on the train becomes ill, it is necessary to call the conductor or the head of the train. He will announce over the speakerphone that they are looking for a doctor among the passengers to provide first aid. If there is no doctor, an ambulance is called to the nearest station, and the train will stop there, even if the stop is not scheduled according to the schedule.

Actors serve you

The conductors of some branded trains take compulsory acting courses. There they are taught to speak beautifully, move and even just stand on the platform, and they are also told how to always look good - including in difficult road conditions.

Anyone can become a conductor

Getting a job as a conductor is much easier than being a steward. To do this, you need to contact the nearest railway depot, from where you will be sent to a three-month course. Pass the exam after graduation - and you can get a job! The main thing is to be able to not sleep for 24 hours.

If you want to be promoted to the head of the train in the future, courses are not enough: you need to get a higher education and work in various sections of the railway.

There is a shower!

It's not a myth, it exists! Now there are showers in many branded trains between St. Petersburg and Moscow, and you can use it for a small fee. For example, in double-decker trains it will cost only 150 rubles, you can pay the conductor (in cash or by card if there is a terminal in the car). Most importantly, do not forget a towel and rubber slippers: they will not be given to you on the train. Splashing for a long time will not work either, only 16 liters of hot water are allocated per person.

studio games

Few people know, but the cost of your ticket includes the use of board games: dominoes, checkers and chess. They can be asked from the conductor, but, however, not all trains have games.

Take a seat closer to the conductor

Choose seats at the beginning of the car, closer to the conductor's compartment. There are several bonuses at once: firstly, tea will be brought faster. Secondly, if the neighbors make noise, more chances that the conductor will hear and come to reassure. Plus, there will be a couple of steps to sockets and titanium with boiling water. And you will be among the first to leave, as in the business class of an airplane.

See What You're Buying

Before buying a ticket, search the Internet for information about the cars of the train you are interested in. Prices for tickets in cars of different classes may differ by 100-200 rubles, but one will have air conditioning and a vacuum toilet, while the other will not.

Search in neighboring classes

There are times when higher-class tickets are cheaper than a reserved seat/coupe or only slightly more expensive. Therefore, when searching, do not limit yourself to only the cheapest reserved seat, see all the options.

How to buy the bottom two seats

... Or the top two. If you have ever bought tickets through the Russian Railways website, then you know that it is impossible to buy the top two shelves there: for some reason, the site offers to take two seats on one side of the table (top and bottom). The solution is simple: buy tickets on other sites.

Extend your trip for free

You can get off at any station and within 10 days continue your journey free of charge on the same ticket, you do not need to buy a new one. To do this, you need to find the head of the station at which you got off, and issue a "stopover" with him.

Do not slow down when issuing a ticket

The role plays every hour! The amount that will be returned if you decide to return the tickets is tied to the time, and the time depends on where you bought the ticket: in Russia, the CIS countries or abroad.

In Russia

Almost all the money spent can be returned only if more than 8 hours are left before the train departure: you will be charged a refund fee (192 rubles 70 kopecks as of September 2017), and the rest of the amount will be returned.

If before departure from 8 to 2 hours, the arithmetic becomes more complicated: you will be refunded 100% of the cost of the ticket and only 50% of the cost of the reserved seat. Here you need to clarify: the ticket consists of two parts - the cost of the ticket itself (fare) and the cost of the reserved seat (fee for a seat in the car, and it doesn’t matter if you are traveling in a SV, compartment or reserved seat).

If less than 2 hours are left before departure, you can return 100% of the ticket price, but the entire part of the reserved seat and the refund fee will be withheld. You can return the ticket even after the train has left, the main thing is that no more than 12 hours have passed from that moment.

What part of the ticket price falls on the reserved seat, you can see in the order information file. It will be sent to your email after purchasing the ticket.

If you are still late for the train, do not relax and still run to the ticket office (the return is usually processed there anyway). Ideally, be in time for an interval of no more than 3 hours after the departure of the train, then there will be no difficulties. If up to 12 hours have passed since the departure of the train, you will need to write a claim statement to return the money. And if the train left within a period of 12 hours to 5 days, the only way to return at least part of the money is to attach proof to the application that the delay was not your fault (a certificate from a doctor, for example, will do). If you just overslept, and then decided to postpone the trip to the station, you will not be able to get the money back.

To the CIS and the Baltics

The full amount, minus the refund fee, can be received if the tickets are returned no later than 24 hours in advance. Less than a day is left before departure, but more than 6 hours - then you will be refunded 100% of the ticket price and 50% of the reserved seat (and withhold the fee). 1 hour before departure, you can get 100% of the ticket price, and the reserved seat cannot be returned. And if the train leaves in an hour, then tickets can no longer be returned, and you will lose money.

To foreign countries

The full amount will be refunded if you manage to return the ticket no later than 6 hours before the train departure, you will only have to pay a refund fee (for international destinations it is 10 euros). If the train leaves in less than 6 hours, the ticket cannot be returned.

When traveling by train, be sure to think about the problems that may arise along the way. This is especially true for people who have chronic diseases or other health problems.

• A huge crowd of people in a confined space several times increases the risk of catching all kinds of infections. Therefore, it is advisable to avoid close contact with other passengers whenever possible, use only disposable hygiene products and disinfect hands several times a day with special liquids. Indeed, on the handles of vestibules and all parts of the train there is a huge amount of microbes.
• Boiled water containers, which are constantly carried by passengers in the cars, can also pose a danger. In this case, sudden braking in this case increases the risk of getting burned. Sudden stops can also lead to injury.
• On a trip, you should take only those products, the quality of which will remain worthy even after a few days. This rule is especially true for long trips. Otherwise, the risk of getting food poisoning increases significantly.
• insufficient ventilation, a large number of dust, especially in summer, increase the risk of complications in people with asthma and allergies.

As you can see, there are more than enough situations where medical intervention may be needed on the train. Therefore, be sure to bring a first aid kit with all the necessary medicines.

You should be aware that all guides are usually medically trained and will be able to provide you with first aid. If, nevertheless, a serious situation arises when the intervention of doctors cannot be avoided, then the train foreman will be obliged to call an ambulance to the nearest station along the route. Arriving at the station medical staff help the patient. If the health problem is life threatening, then the victim is hospitalized in the nearest hospital.

Going on any trip, be sure to find half an hour and think about what you might need on the trip. Then, if necessary, you can help yourself, your loved ones or neighbors in the car.